Dr Lasermed is a grumpy gynecologist who comments about her practice, the state of medicine, women's health care and her triplet children.

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These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.

Thursday, September 1, 2011

Oops, you need to see another doctor…

I saw a patient the other day that had a diagnosis from her dermatologist of lupus.This connective tissue disease is usually managed by a rheumatologist.Now, many internists can manage these diseases.However, this woman is having many different problems that may be related to the lupus.

I was doing a “review of systems”.She was having problems with her eyes, her stomach, and other issues.Since these problems had started at different times, nobody had put them together as possible symptoms from the lupus.She had seen her medical doctor for each individual problem and the dermatologist for the rash.

Because I generally see my patients once a year, I ask for a summary of what has happened since the last time they were in my office.I have also adopted the dreaded EMR (Electronic Medical Record), which means that I have to review the entire history and enter it in my computer.So I am catching things that I might not have noticed before.{Dang it, I guess maybe there is a reason for those EMRs after all – don’t tell anyone I said that}

The dermatologist did not refer her for treatment of the lupus.He just gave her a cream for the rash.The internist has been treating her symptoms as they present, not knowing about the lupus.Sooooo….

Screech.Put on the brakes.Stop everything.

Unfortunately, I have only general ideas about what to do here.It’s not in my “scope of practice”.Remember – I’m a gynecologist.However, I do know where to send her.I’m good at identifying when someone needs to see another specialist.She may need some different medication, testing, or other fancy stuff.

As we were discussing her hot flashes and the possibility of hormone treatment, we decided she would hold off until she saw the rheumatologist.These could be related to the lupus.Or NOT…..So she might be back for more discussion about menopause issues if the hot flashes and night sweats are not related to the lupus.

But first I have to fill out that danged referral form.You know how I feel about forms……

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The band my kids march in

Characters

I'm Dr. Lasermed. I'm a Gynecologist (that's a doctor that takes care of women and women's problems). I've been in private practice for over a quarter of a century.Mr. Lasermed - a paramedic in his former life, married me without fully realizing how crazy it is to have a physician for a spouseThe Lasermed children (triplet boys):Mr. Impatient - sweet, lovable and impatient. Autistic and very bright. He loves sports (all kinds). He is also very routine oriented.Three Speed- originally two speed - slow and stop. However, has ADD, so third speed is "....look, there's a bunny". Very bright when we can get him to focus. Plays trumpet.Tall Guy- First one to be taller than Mom - calls me "short woman" - probably the smartest of the three - definitely the most sarcastic. Plays the baritone (and alto) saxophone.Princess – my faithful and kind receptionist who puts up with me when I’m cranky and puts up with my patients who are crazy. She has two wonderful boys and a boyfriend and Mom who may or may not appear in the blog.Yearbook Gal – Tall Guy’s girlfriend and photographer for the yearbook.Computer Geek - formerly had a name, now changed at his request because he wanted a nickname, too. He helps me out when I get stuck with the computer issues.

About Me

I am a Gynecologist (a doctor who cares for women and women's problems). I went to medical school in the south, residency in the frozen north (with a small side trip to Canada), then moved to a "medically underserved area" I have endured riots, hurricaines, tornados, floods and triplets.
My triplet boys are about finished with high school. Two of them are in the marching band. See the photo. I am very proud of them.
I also write as Dr. Maryellen Smith on associatedcontent.com Follow me on twitter @ lasermed1
I appreciate feedback.

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I would like to state for the record that any and all mistakes are those of the blogger. I am in my mid-50s. When I was first introduced to computers, I actually punched cards. I never figured out how to write in all those funny languages. I have recently tried to post pictures with my articles. Nope. I forget to put tags on posts. Sorry. Be patient with me. I will eventually get it. I am trainable.

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Disclaimer

*****This blog is not intended to give medical advice. You should always check with your doctor. Note I did not say "provider". You should read the blog to see why.

Any resemblance of characters to people you think you might know, living or dead, is totally coincidental. Really. Unless I asked them if I could use the story. Even then, details have been changed to protect somebody.

I can't ask about places. Soooooo..... Any resemblance of places to someplace you think you know is absolutely coincidental.